综合干预对农村精神分裂症患者家庭环境的影响

目的 探讨生物-心理-社会综合干预措施对农村精神分裂症患者家庭环境、情感表达的影响。方法 将符合入组条件的300例患者分为干预组和对照组,每组各150例。两组均服用小剂量抗精神病药(折合氯丙嗪剂量为<300 mg/d),共3年;同时对干预组实施生物-心理-社会综合干预。于入组时和随访时(每半年评定1次,共7次)对患者评定家庭环境量表、坎伯威家庭问卷和家庭会谈量表。结果(1)入组时,两组患者家庭环境及家庭负担的差异均无显著性;干预组家属热情性和赞扬性因子分高于对照组(P<0.05)。(2)研究结束时,干预组患者的情感表达和矛盾因子分低于对照组(P<0.01),亲密度、独立性、成功性、文化性、娱乐性、组织性和道德性等因子分均高于对照组(均P<0.01-0.05),对其家庭娱乐影响、对家人的躯体健康、心理健康影响及家庭负担总分均低于对照组(P<0.01)。干预组家属的批评、敌对和情感参与等因子分低于对照组(P<0.05～0.01),热情性、赞扬性等因子分高于对照组(P<0.01)。结论 生物-心理-社会综合干预方法对农村精神分裂症患者能有效地改善家庭环境、降低照料者的情感表达,并减低患者的疾病严重程度。

Effects of synthetical intervention on family environment in rural schizophrenia

Objective To explore the effects of synthetical intervention on family environment and emotion express in schizophrenia family and its relation with the efficacy of antipsychotic treatment. Methods In this 3-year follow-up study, 300 schizophrenics with their family receiving chlorpromazine equivalent daily dose of 300 mg were involved in the study, and were randomly divided into intervention group and control group. The intervention group was additionally combined with bio-psycho-social intervention. All subjects were evaluated using the Family Environment Scale ( FES) , affect express scale every 6 months. Results Intervention group showed significantly better family environment, and had less family burden, poorer emotion express of the main guardian than control group. The illness severity of patients was positively correlated to the FES factor of emotion express, affect express scale factors of affect excessive participation and hostile, and was negatively correlated to Family Environment Scale factors of organization and moral religion. Conclusion The synthetical bio-psycho-social intervention can effectively improve family environment, decrease emotion express of the guardian, reduce illness severity in rural schizophrenia.